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Seizures and status epilepticus can occur within 14 days following the administration of inactivated and live-attenuated vaccines. These vaccine-proximate seizures can undermine parental confidence in vaccine safety and affect further vaccination decisions. A recent study suggests that there is no contraindication to administering routine vaccines in children with epilepsy or febrile seizures. The study findings were published in the European Journal of Pediatric Neurology on December 03, 2021.

Few studies have shown that vaccination may slightly increase the risk of seizures in patients with epilepsy after immunization, but the benefits of vaccination outweigh the risks. However, there is no evidence from large cohort studies that vaccinations are associated with afebrile seizures or that immunization causes epilepsies in healthy populations. To further explore, Dr Dana Craiu and her team conducted a study to assess the evidence relating vaccination to febrile seizures and epilepsy is evaluated with an emphasis on febrile seizures (FS), Dravet syndrome (DS), West syndrome, and other developmental and epileptic encephalopathies.

The researchers performed a systematic literature review using search words vaccination/immunization and febrile seizures/epilepsy/Dravet/epileptic encephalopathy/developmental encephalopathy. They analyzed 120 articles for the role of vaccination as the cause/trigger/aggravation factor for FS or epilepsies and preventive measures.

Key findings of the study:

  • Upon analysis, the researchers found no evidence that vaccinations cause epilepsy in healthy populations.
  • They noted that vaccines do not cause seizures but may trigger seizures in structural/genetic developmental & epileptic encephalopathies.
  • Although first seizure in DS maybe earlier in vaccinated than in non-vaccinated patients, they observed similar developmental outcomes in both groups.
  • They also observed that certain combination vaccine types may increase the risk of febrile seizures. However, they noted that the public health benefit of separating immunizations has not been proven.

Recommendations:

  • They recommended, “Children with a personal or family history of FS or epilepsy should receive all routine vaccinations. This recommendation includes DS.”
  • They recommend against vaccination only if there is an active illness.
  • They further advised the administration of acellular pertussis DTaP (diphtheria-tetanus-pertussis).
  • They suggest measles-containing vaccine should be administered at the age of 12–15 months.
  • They further advise against prophylactic antipyretics with vaccination except in Dravet syndrome.

Vaccination against SARS-CoV2

Vaccines for COVID 19 is available in children over the age of 5 years. Neurological comorbidities, including epilepsy, are a risk factor for severe COVID-19.

Concerning COVID Vaccination, the authors wrote, “Vaccination against SARS-Co-V2 infection proved to be well tolerated and with no side effects in children with epilepsy, including DS”

The authors concluded, “Although immunization has been one of the great successes of medicine and has saved millions of lives worldwide there is a powerful, vocal, though poorly informed anti-vaccination movement which can influence the views of parents of children with neurological disorders… Parents and vaccine providers can be reassured that children with epilepsy do not have an increased risk of seizures requiring medical attention after immunization compared to their baseline risk… Health professionals should proactively offer explanations about disease consequences and vaccination risks and benefits to families with children with epilepsy.”

SOURCE: medicaldialogues.in,

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